Close-in Research Articles

Disorders of mental health in children and adolescents with hematological malignancies

Introduction. The success in pediatric oncohematological disorders treatment cause increasing scrutiny not only to remission achievement and long-term patient survival, but also to supportive dysfunctions, which go with malignancy and anti-tumor treatment. Blood tumors cause all organs and systems disorders, and psychic dysfunctions of these are not in the last place.Aim. To characterize mental health and psychic disorders types in children and adolescents with oncohematological diseases during hospital stay.Materials and methods. It was analyzed mental health of 169 children and adolescents with hemoblastoses, who were treated at Pediatric Oncology and Hematology Research Institute of National Research Cancer Centre n. a. N. N. Blokhin (Moscow, Russia) in 2022 year. 50 (29.6 %) patients needed a psychiatric consultation. Among oncohematological disorders acute lymphoblastic leukemia was predominated – 25 (50 %), lymphomas – 17 (34 %) and acute myeloid leukemia – 8 (16 %) patients. Mental health data assessed after examination/consultation of clinical psychologist and psychiatrist.Results. Asthenia was found in all 50 (100 %) patients, who were recommended a psychiatrist consultation, in 47 (94 %) – adjustment disorder, in 15 (30 %) – vexatious and neurotic disorder, in 16 (32 %) – affective syndromes, less often (18 and 14 % respectively) – behavioral deviations and eating disorders. As single cases in 2 (4 %) patients an intellectual disability and in 1 (2 %) a psychotic syndrome were diagnosed. As a role the most pronounced psychopathological conditions were upon admission to the hospital and decreased during the treatment and adaptation.Conclusions. One third of children and adolescents, hospitalizing to oncohematological clinic need a psychiatrist consultation. Multidisciplinary care for such patients with pediatric oncologist, psychiatrist and clinical psychologist can cure psychogenic disorder effectively, improving the stay of patient at the hospital and best compliance between the doctor and patient.

Indicators of quality of life, anxiety-depressive symptoms and severity of dysmenorrhea in adolescent girls with peritoneal endometriosis during conservative therapy for a year

Introduction. Delayed diagnosis and treatment of endometriosis lead to impaired quality of life and pain chronification in young female patients.Aim. To study indicators of quality of life, anxiety, depression and pain syndrome in adolescents with peritoneal endometriosis (PE) over a one-year period of conservative therapy.Materials and methods. A total of 45 girls aged 13 to 17 years with a confirmed diagnosis of PE were enrolled in a prospective longitudinal study. Pain syndrome (VAS, McGill Pain Questionnaire), anxiety-depressive symptoms (Beck Depression Inventory (BDI), Hospital Anxiety and Depression Scale (HADS), Spielberger State-Trait Anxiety Inventory (STAI)), quality of life indicators (SF-36) were assessed before and after one year of treatment in female patients (dienogest administered continuously, NSAIDs and drotaverine for immediate pain relief only).Results. One year of therapy resulted in a significant decrease in the severity of dysmenorrhea and chronic pelvic pain, gastrointestinal symptoms and dysuria, daily activity and productivity impairment (p < 0.001) in girls with PE. In addition, the study demonstrated decreased indicators of anxiety and depressive disorders (BDI depression, HADS anxiety and depression, STAI reactive and personal anxiety (p < 0.001)) and an improvement in quality-of-life indicators (physical and psychological component, average index (p < 0.001)). There was a declining trend in blood hormone and inflammation test results within the reference range during treatment. The estradiol level has been shown to be a risk factor for high levels of affective disorder symptoms in adolescents with PE: STAI reactive anxiety (p = 0.046), HADS anxiety and depression (p = 0.044 and 0.033, respectively).Conclusion. The one-year therapy of PE in adolescents (dienogest administered continuously, a combination of NSAIDs and drotaverine in pain syndrome only) was associated with significantly improved quality of life, decreased severity of anxietydepressive disorders and pain, which confirms the need to start therapy when symptoms of the disease begin to show them-selves in adolescence.

Risk of developing psychiatric disease among adult patients with skin disease: A 9-year national register follow-up study in Norway.

The existing association between skin disease and psychiatric comorbidity has gained attention during the last decades. Stress and mental illness can directly or indirectly affect skin disease, while dermatological conditions, known to impair life quality and mental well-being, can promote psychiatric conditions. The aim of this study was to assess the risk of developing psychiatric disease among adult dermatological patients over a period of time. The secondary objective was to see which psychiatric disorders developed most commonly, and which skin diseases posed the greatest risk for later mental health issues. Adult dermatological patients were followed for 9years (2008-2016) using the Norwegian Patient Registry, for both outpatient and inpatient specialist healthcare services. Dermatological patients were identified during the first 2years and were then followed for psychiatric comorbidity prospectively for the next 7years.Cox regression models were applied to estimate the risks of psychiatric disorders among patients with skin diseases. Estimates were adjusted for age and gender differences. Hazard risk ratios (HR) with 95% CI are reported. Dermatological patients developed depressive disorders most frequently (4.1% vs. 2.3% in non-dermatological participants), followed by anxiety disorders (3.3% vs. 1.8%), and adjustment disorders (2.6% vs. 1.5%). Developing depressive disorders showed the highest HR among dermatological patients, HR (95% CI)=2.5 (2.4-2.5), followed by disorders related to alcohol use, HR (95% CI)=2.2 (2.1-2.5), and anxiety disorders, HR (95% CI)=2.1 (2.1-2.2). Papulosquamous disorders were the skin conditions with the highest HR for developing a mental health condition, with depressive disorder having HR (95% CI)=2.6 (2.5-2.9); anxiety disorders at HR (95% CI)=2.9 (2.7-3.1); and disorders related to alcohol use at HR (95% CI)=3.2 (2.8-3.6). The study demonstrates that having a skin disease doubles to triples the risk of developing a psychiatric illness within 7years, especially depression, anxiety, and alcohol use compared with the general population.

B - 08 Differences in Memory Performance between Adjustment Disorder and ADHD among Children.

To measure the differences in cognitive performance between a sample of children diagnosed with adjustment disorder (ad) and ADHD. Participants were selected from a de-identified child outpatient clinical database. The ad group (n = 257; Mage = 8.75, SD =2.03; Med = 3.07, SD = 1.86) had 61.5% male, 47% White, 19.2% Black, 26.3% Hispanic, and 7.2% other race. The ADHD group (n = 149; Mage = 7.85, SD = 1.84; Med = 2.23, SD = 1.74) had 75.3% male, 54.1% White, 17.6% Black, 18.8% Hispanic, and 9.4% other race. Groups differed on age and education. ANCOVAs were used to test differences between groups controlling for significant covariates. At the group level, individuals with ad performed significantly better than those with ADHD on the WISC-IV working memory index [F(1, 127) = 8.10, p = 0.01], WRAML-2 verbal memory index [F(1, 163) = 11.81, p < 0.001], visual memory index [F(1, 161) = 4.48, p = 0.04], attention and concentration index [F(1, 153) = 13.27, p < 0.001], general memory index [F(1, 161) = 12.89, p < 0.001], screening memory index [F(1, 141) = 9.35, p = 0.003], and general recognition index [F(1, 152) = 8.57, p = 0.004]. Individuals with ADHD tend to have deficits in encoding and digesting information, which can create memory-retrieval difficulties. Meanwhile, individuals with ad may experience intrusive memories that gradually fade away and do not interfere with short- or long-term memory retrieval, and may partially explain their better performance in memory tasks. Limitations of the study include the lack of premorbid measures of memory ability and lack of information about comorbidity. Future research could explore the impact of different ADHD presentations on memory ability.

Experimental study on low-altitude UAV-to-ground propagation characteristics in campus environment

In recent years, unmanned aerial vehicle (UAV)-to-ground wireless channels have become focused areas. Thus a better understanding of UAV-to-ground wireless channel characterizations is critical. The large-scale fading characterization is widely analyzed in many research works. Nevertheless, the small-scale fading characterization of low-altitude UAV-to-ground propagation has not been fully modeled. In this work, the close-in (CI) free space and floating-intercept (FI) path loss models are implemented to characterize large-scale fading. The large-scale parameters, i.e., path loss exponent (PLE), shadow fading standard deviation (STD), and shadow fading correlation coefficient, are carefully extracted, analyzed, and compared. Regarding small-scale fading, Akaike’s Information Criteria (AIC) is used to find the most suitable fading distribution. In addition, fade depth (FD), level crossing rate (LCR), and average fade duration (AFD) are also calculated. The quantitative results and comparisons show a noticeable difference with ground propagation. The parameterized models are helpful for further understanding and deployment of UAV-to-ground wireless communication systems.

ROLE OF PSYCHIATRY IN PALLIATIVE CARE - A CASE REPORT

Palliative care aims to improve the quality of life for individuals facing life-threatening illnesses by addressing physical, psychological, social, and spiritual needs. While palliative care traditionally emphasizes symptom management and pain relief, the role of psychiatry in this field has gained recognition as an essential component of comprehensive patient-centred care. This case report provides an overview of the evolving role of psychiatry in palliative care, highlighting its significance in addressing the complex emotional and psychological aspects of end-of-life care.Psychiatrists play a crucial role in assessing and diagnosing mental health conditions that often co-occur with serious illnesses, such as depression, anxiety, and adjustment disorders. Identifying and addressing these conditions is vital to improving patients overall well-being. Psychiatric interventions are valuable in managing distressing psychological symptoms, including anxiety, depression, delirium, and existential distress. Appropriate pharmacological and psychotherapeutic interventions can alleviate suffering and enhance the patients overall comfort. Collaborating with Palliative care specialists, psychiatrists provide psychosocial support to patients and their families, helping them cope with the emotional challenges that arise during the end-of-life journey. This includes facilitating open and honest communication, addressing complex family dynamics, and assisting in advanced care planning.In conclusion, the role of psychiatry in palliative care is expanding to meet the complex needs of individuals facing life-limiting illnesses. Recognizing and addressing the emotional and psychological aspects of end-of-life care not only improves the patients quality of life but also contributes to a more compassionate and comprehensive approach to palliative care. Integrating psychiatry into palliative care services ensures that individuals receive the support they need to navigate the challenging journey of serious illness with dignity and comfort.

Cotard’s Syndrome in Adolescence: A Case Report

Cotard’s syndrome is a rare neuropsychiatric condition characterized by nihilistic and hypochondriacal delusions that generally occur in individuals with some predisposition or in association with a psychiatric or organic disease. Its development is even more unusual in pediatric population.The purpose of this paper is to briefly review the available scientific evidence, based on the description of a clinical case. Data were obtained from clinical records and a careful search and analysis on the electronic databases PubMed and Embase. We illustrate the case of a 15-year-old female adolescent with Cotard’s syndrome in the context of an adjustment disorder. Cotard’s syndrome can be associated with chronicity, self-neglect and suicide, but a prompt diagnosis and treatment can promote a good outcome. This case shows how the use of antipsychotics complemented by psychotherapeutic and psychoeducational interventions can promote a complete remission of the condition.

Trajectories of Adjustment Disorder and Well-Being in Austria and Croatia during 20 Months of the COVID-19 Pandemic.

The present study aimed to investigate the trajectories of adjustment disorder (AD) symptoms and well-being over 20 months of the COVID-19 pandemic in Austria and Croatia. Further objectives of this study were to examine whether sociodemographic characteristics and the symptoms of anxiety and depression could predict these trajectories. As part of the pan-European ESTSS ADJUST study, N = 1144 individuals were recruited using convenience sampling and assessed four times between June 2020 and January 2022 through an online survey. Latent growth curve modelling was applied to estimate the trajectories of AD symptoms and well-being. Over time, the prevalence of probable AD varied between 9.8% and 15.1%. The symptoms of AD tended to increase, whereas well-being tended to decrease. According to the majority of the models tested, women, participants from Austria and those with lower income had higher initial AD symptoms, whereas older participants and those from Croatia had higher initial well-being. In all models and at all timepoints, anxiety and depression significantly predicted AD and well-being scores. Overall, our study points to several predictors of AD and well-being and indicates high variability in people's reactions to the pandemic. Psychosocial support for the general population is needed during pandemics and similar crises, with a special focus on vulnerable groups.

A predictive model of herpes zoster after allogeneic hematopoietic stem cell transplantation: VZV reactivation following antiviral prophylaxis discontinuation.

Herpes zoster (HZ) refers to the rash appearing on dermatomes due to varicella zoster virus (VZV) reactivation. The incidence of HZ is significantly higher in allogeneic hematopoietic stem cell transplantation (allo-HSCT) recipients than in non-HSCT recipients. Although acyclovir prophylaxis is routinely administered to every allo-HSCT recipient for 1 year after transplantation, some individuals eventually develop late-onset HZ after completing prophylaxis. Little information is known about the clinical features of HZ after prophylactic antiviral treatment discontinuation, and an effective predictive model of late-onset HZ needs to be established. A total of 3366 patients who had received allo-HSCT from 2012 to 2017 were included in our study, among whom 201 developed HZ after 1 year (late-onset HZ). We designed a nested case-control study to identify potential predictors of late-onset HZ. Finally, we established a predictive model using binary logistic regression analysis. Age (p < .001), use of immunosuppressants at +1 year (p < .001), CD4-CD8 ratio at +1 year (p < .001), certain mental disorders (depression, anxiety, insomnia and adjustment disorder) (p < .001), engraftment time of neutrophils (p < .001), and CD8+ cell count at +30 days (p < .001) were independent predictors of late-onset HZ. A risk grading system was established based on regression coefficients. Discrimination and calibration analysis indicated that the model had good performance. We also identified several predictive factors of the incidence of HZ-related complications. This is the first scoring system for predicting the incidence of late-onset HZ after allo-HSCT. This model can be applied to identify individuals at high risk of late-onset HZ in the early period after receiving allo-HSCT.

Understanding Treatment Anxiety and Utility of Mixed Media Educational Tools in Radiation Oncology Consultation: A Qualitative Study

Anxiety and adjustment disorders are prevalent in cancer patients, especially at the initiation of treatment, which may be alleviated by improved communication at initial consultation. The purpose of this study is to explore patients' needs in how radiation consultation may improve treatment-related anxiety and the role of multimedia visual tools. Eight patients previously treated with partial or whole breast irradiation at our institution were interviewed in a semi-structured manner at a median of 1.54 months (range 0.13 - 12.42) after they completed radiation. Interview questions included expectations prior to consultation, experience of consultation and treatment, and the role of augmented reality or multimedia tools. Two independent reviewers performed an inductive, thematic analysis to generate themes and subthemes (inter-rater reliability = 0.79). Four main themes were identified in thematic analysis: information expectations, anxiety, personalized education, and visual aids. Patients described preconceptions of radiation, desire for greater volume of information, importance of repetition from providers, benefit of seeing treatment set-up during simulation, and frustrations with the breath-holding process. Anxiety was related to fear of the unknown, difficulty remembering information when anxious, difficulty asking questions, and ambiguity of information worth worrying about. Patients expressed a desire for personalized education, including accounting for prior health conditions, varying health literacy, preference for individualized presentations, and minimizing extraneous input from those not on the healthcare team. Patients desired visuals during consultation, favored 3D technology over 2D mediums, acknowledged differences in learning style, and preferred an interactive component of patient education done in conjunction with visual tools. While verbal consultation process provides valuable education regarding radiation treatment, patients continue to experience anxiety attributed to fear of the unknown. Augmenting the standard initial consultation with interactive visual aids, particularly in the form of a 3D medium, may enhance the patient experience at time of consultation. The results of this study will inform the development of a patient educational tool and clinical study named Curie therapy User eXperience (CurieUx) to be used during radiation oncology consultations.

Provision of Cognitive Behavior Therapy for Depression and Anxiety Disorders by Medical Student Trainees.

The purpose of the article is to evaluate an innovative education program in which medical students were trained in cognitive behavior therapy (CBT) and provided CBT treatments under supervision to uninsured individuals with depressive, anxiety, adjustment, and trauma-based disorders. The authors assessed improvements in trainees' CBT knowledge using the Cognitive Therapy Awareness Scale before and after their didactic training. CBT supervisors rated trainees' clinical competencies utilizing standardized checklist evaluations based upon supervision reports. The authors employed mixed effects ANOVA and regression modeling to test the association between the addition of CBT to treatment as usual (TAU) and improvements in patients' depressive and anxious symptom severity. The authors collected feedback and self-assessment of functioning with a Psychotherapy Feedback Questionnaire. Medical students showed increases in CBT knowledge that were maintained six months later and demonstrated satisfactory competency in CBT techniques. The addition of CBT to TAU was associated with greater improvements in depressive, but not anxious, symptom severity. However, among the TAU + CBT group, there was an association between the number of CBT sessions received and the magnitude of improvement in anxious symptoms from baseline. Patients gave positive feedback to medical student CBT providers and reported improvements in broad domains of psychosocial functioning. Medical students can provide competent and clinically beneficial CBT treatments for depression and anxiety disorders. These findings have implications for medical training and support the use of medical students to deliver care for individuals with limited access to psychotherapy.

Psychiatric disorders in inpatient Ethiopian migrant workers in the United Arab Emirates.

Migrant workers have higher rates of mental health problems than non-migrant workers, with Ethiopian migrant workers in the United Arab Emirates appearing to be overrepresented in the psychiatric inpatient population compared with their numbers in the general population. We sought to investigate the pattern of psychiatric inpatient admissions in Ethiopian migrant workers over a 10-year period (2011-2020) in order to highlight demographic and clinical characteristics, and to investigate factors predicting the length of hospital stay. We reported the mean and frequency of demographic and clinical data of Ethiopian psychiatric inpatients at one of the largest governmental hospitals in eastern Abu Dhabi between 2011 and 2020, and investigated factors predicting length of stay in hospital using linear regression. Our results show that Ethiopian expatriates made up 7.9% of all admissions over a 10-year period, had a mean length of hospital stay of almost 20 days, with 98.1% of them being female, 92.8% being domestic workers, 90.1% having a language barrier, 57.4% being single and 55.5.% having one or more recent stressors prior to admission. The most common diagnoses were acute stress reaction (31.6%), psychosis (29.3%), bipolar disorder (14.8%) and adjustment disorder (11.0%). Work-related stress, termination of employment and several clinical factors significantly predicted length of stay in hospital.

Psychopathological profile before and after bariatric surgery

Presurgical psychopathological assessment usually focuses on detecting severe mental disorders. However, mild intensity psychopathology and eating behaviour pattern may also influence postsurgical outcomes. The aim was to identify psychopathology and eating behaviour pattern in candidates prepared for bariatric surgery compared to a normative population before and after surgery. A cohort of 32 patients seeking bariatric surgery in a university hospital between March 2016 and March 2017 were evaluated with Personality Assessment Inventory (PAI), 36‐item EDE‐Q and BES before and after surgery. Thirty-two patients before and 26 one year after surgery were included. The PAI presurgical psychometric profile suggested a mild mixed adjustment disorder focused on somatic complaints. After surgery, patients improved in somatic complaints (p < 0.001), and depression (p = 0.04). Related eating disorders were more common than those of the normative group and improved significantly after surgery in scores for compulsive intake (BES p < 0.001) and overall key behaviours of eating disorders and related cognitive symptoms (EDE-Q/G p < 0.001). In our cohort ready for bariatric surgery a mild psychopathological profile is still present and becomes closer to that of the normative group after surgery. Further studies are needed to evaluate the effects of mild psychopathology on outcomes after bariatric surgery.

The Association Between Mental Health, Substance Use Disorder, and Outcomes After Total Joint Arthroplasty

BackgroundPrior studies suggest that distressed patients or those who have poor mental health have inferior postoperative outcomes when compared to nondistressed patients. However, these studies typically do not account for substance use or other comorbidities often found in this population, which can independently contribute to postoperative complications. This study sought to control for these factors and assess if a diagnosis of a mental health condition is directly associated with worse outcomes after total joint arthroplasty. MethodsA retrospective chart review was performed for 3,182 patients who underwent a total hip arthroplasty and 4,430 patients who underwent a total knee arthroplasty. Diagnosis of the mental health disorders included depression, anxiety disorder, adjustment disorder, bipolar disorder, trauma, stressor-related disorder, and schizophrenia or schizoaffective disorder. Multivariable analyses were performed to control for alcohol use, drug use, tobacco use, body mass index, and a comorbidity index. ResultsWhen controlling for body mass index and Charlson comorbidity index, no statistically significant associations were found between a diagnosis of any mental health condition or a specific diagnosis of depression or anxiety, and 90-day readmission, reoperation, or 1 year mortality for patients undergoing total knee arthroplasty or total hip arthroplasty. ConclusionsWhen accounting for confounding factors, there does not appear to be a direct association between diagnosis of any of the psychiatric conditions we studied and outcomes after primary total joint arthroplasty. While prior studies suggest addressing the mental health condition may improve outcomes, this study suggests that preoperative medical optimization and potentially addressing substance use may be more effective strategies.

Measurement of work-related psychological injury with depressive symptoms

ObjectiveThis study aimed to measure the level of psychological injury caused by work-related stress as well as the severity of depression among workers.MethodFirst, we conducted an online survey and recruited 500 workers diagnosed with depression or adjustment disorder to investigate what type of stress they experienced within six months before onset. Second, we conducted another online survey and recruited 767 participants who experienced some form of work-related stress. All the participants were classified into four groups by whether or not they were diagnosed with depression and whether or not they quit their jobs due to work-related stress. We used the Impact of Event Scale-Revised (IES-R) to measure psychological injury caused by work-related stressful events and the Patient Health Questionnaire (PHQ)-9 to assess the severity of depression.ResultsIn study 1, 62.4% of workers diagnosed with depression or adjustment disorder experienced work-related stress within six months before onset. In study 2, the IES-R mean scores were 40.7 (SD = 23.1) for Group A (workers with depression and quit their jobs) and 36.67 (SD = 23.4) for Group B (workers with depression but stayed at their jobs), with both exceeding the cut-off point (24/25) of PTSD (Post-Traumatic Stress Disorder), while the mean score of Group C (workers who did not have depression but quit their jobs because of work-related stress) was 20.74 (SD = 21.2), and it was 13.89 (SD = 17.4) for Group D (workers who had work-related stress but stayed at their jobs), with both of them below the cut-off point of PTSD. The total scores of IES-R of Group A and Group B were significantly higher than those of Group C and Group D(p < 0.001). There was a significant positive correlation between the scores of IES-R and PHQ-9 for all four groups (r = 0.708).ConclusionsThis study suggests that it is necessary to measure not only depressive symptoms but also the level of psychological injury resulting from stressful events in the workplace to assess workers with depression.

Hormonal profiles and adjustment disorders in adolescent girls with menstrual abnormalities and comorbid pathology

Background. The reproductive health of girls has acquired great social significance in connection with the problem of quantitative and qualitative reproduction of the population. The purpose of the study was to determine the hormonal status of adolescent females with menstrual disorders and various somatic pathologies and to investigate the state of adaptive-compensatory capacities in these patients. Materials and methods. The hormonal background was studied in 391 girls aged 12–17 years: 175 with abnormal uterine bleeding (AUB) and 216 with oligomenorrhea (OM). All patients were examined by a multidisciplinary team. Results. A comorbid pathology was found in the absolute majority of girls with menstrual abnormalities. Endocrine disorders were noted more often (pϕ &lt; 0.001–0.00001). Indicators of hormone concentration in patients with menstrual disorders had no significant differences depending on the type of comorbidity. Probable changes in the content of some hormones were observed depending on the type of menstrual disorders. A significant increase in the level of luteinizing hormone (pu &lt; 0.02) and a decrease in estradiol (pu &lt; 0.02) were observed in patients with OM compared to those with AUB. The assessment of the adjustment state revealed that in girls with menstrual disorders, the average cortisol content did not differ from that of controls, and insulin was higher than in the comparison group (pu &lt; 0.001). Ho­wever, high cortisol values (above 90 percentile) were noted in 8–13 % of patients with AUB and OM. The stress index (C/In) as a marker of a nonspecific stress response was lower than in the comparison group (pu &lt; 0.0001), and it was probably higher in girls with OM than in adolescents with AUB (pu &lt; 0.004). Conclusions. An interdisciplinary approach is a mo­dern strategy in the treatment of menstrual disorders in adolescence. A decrease in the stress index was found in girls with menstrual disorders, which may indicate a decrease in adaptive capacity. Moreover, adolescents with OM are more adjusted to menstrual disorders than girls with AUB.

Adjustment disorder and its risk factors during the solid organ pre-transplant period for children: A retrospective analysis of the last 10 years.

Adjustment disorder (AD) in individuals suffering from end-stage organ failure can negatively impact treatment adherence and overall quality of life. Previous research focusing on adults has suggested that AD might serve as a precursor to major mental disorders. However, although it is frequently used as a diagnosis in consultation-liaison psychiatry, our understanding of AD in pediatric transplant candidates remains limited. Therefore, the objective of this study is to assess AD and identify its associated risk factors among children who are candidates for heart, kidney, and liver transplantation. Data were collected retrospectively from a cohort of 155 children, aged between 6 months and 18 years (mean age 9.4), who had undergone consultations for child and adolescent psychiatry at a hospital with a transplant center within the past 10 years. The predominant diagnosis among children assessed during the pre-transplant period was AD (20%), with the subtype "with depressed mood" being the most commonly observed (35.5%). Organ type and length of hospital stay were identified as significant independent predictors of AD. Being a heart transplant candidate was determined as the strongest predictor of AD among children who underwent consultations with child and adolescent psychiatry within the population of transplant candidates. The study found that AD was the most common diagnosis among transplant candidates who underwent psychiatric consultations. Additionally, the study identified the length of hospital stay and the type of organ needed as independent predictors of AD. Screening for AD by considering risk factors may provide an opportunity for early intervention before the occurrence of major mental disorders in transplant candidates.

Pandemic-induced increase in adjustment disorders among postpartum women in Germany

BackgroundThe current paper analyzed the effect of the pandemic-induced lockdown on maternal mental health during the first 12 postpartum weeks in Germany.MethodsIn this cohort study, we compared the participants’ anamnestic backgrounds and the results of psychological tests, measuring stress levels, depressive symptoms and attachment. The 327 participants were divided into two groups with one representing the “pre-COVID” sample and the other the “lockdown” sample. We performed multiple comparisons, investigating the distribution of diagnoses and the correlating risk profiles between the two cohorts.ResultsOur analysis showed a significant difference between the two cohorts, with a 13.2% increase in the prevalence of adjustment disorders (AD), but not postpartum depression (PPD), in the first 12 weeks postpartum. However, during the pandemic, women with AD had fewer risk factors compared to their pre-pandemic counterparts. In the “lockdown” cohort, a tendency toward higher stress and lower mother-child attachment was observed in AD.ConclusionsIn sum, we observed some negative impact of the pandemic on maternal mental health. The lockdown might have contributed to an increase in the number of cases involving AD in the postpartum period. The prevalence of PPD (ca. 6–10%), on the other hand, was not affected by the lockdown. Thus, the effect of COVID-19 on maternal mental health might not, after all, have been as severe as assumed at the beginning of the pandemic.

A Quantitative Study on Mental Health, Sleep Quality, and Quality of Life among Family Members of Patients With First-Episode Cancer

This study investigated mental health, sleep quality, and quality of life among family members of patients with first-episode cancer. A survey was conducted with 39 family members of patients with cancer, using the Hospital Anxiety and Depression Scale (HADS), Pittsburgh Sleep Quality Index (PSQI), and Caregiver Quality of Life Index-Cancer (CQOLC). HADS scores indicated that 17 participants (43.6%) had adjustment and/or major depressive disorders. PSQI scores showed that 16 participants (42.1%) had sleep disturbances. However, CQOLC scores were higher than those in previous studies on families of patients with various stages of cancer. Although families of patients with first-episode cancer may not experience difficulties in their lives, their mental and physical conditions may be impaired. Healthcare providers should focus on the impact on the mental health and sleep needs of patients’ families caused by dealing with a loved one with cancer and offer support.

New progress in an old debate? Applying the DSM-5 criteria to assess traumatic events and stressor-related disorders in cancer survivors.

The rather broad definition of medical trauma within DSM-IV has contributed to long-lasting debates on the applicability of Posttraumatic Stress Disorder (PTSD) in oncological patients and its differentiation from Adjustment Disorder (AjD) which results from non-traumatic critical life events. The DSM-5 criteria have introduced a narrower definition of medical traumatization. However, studies on updated prevalence rates in cancer patients are missing. Within a cross-sectional study, we assessed hematological cancer survivors using the Structured Clinical Interview for DSM-5. We investigated (i) the frequency and type of cancer-related stressors, (ii) the proportion of stressors qualifying as traumatic according to DSM-5 (i.e., an event of sudden and catastrophic character) and (iii) the prevalence of PTSD, AjD and cancer-related PTSD according to DSM-5. 291 patients participated (response rate: 58%). Mean age was 54years, 60% were male. 168 patients (59%) reported cancer-related stressors, with the most frequent being cancer diagnosis disclosure (n=58, 27%). Eight percent of reported stressors qualified as traumatic events according to DSM-5. Five (1.8%), 15 (5.3%) and 20 (7.0%) cancer survivors met DSM-5 criteria for current PTSD, lifetime PTSD and AjD, respectively. Among all PTSD cases, three were cancer-related (1.1%). In addition, seven patients (2.5%) metall symptoms for cancer-related PTSD, but not the DSM-5 criterion for medical trauma. Considering receiving the cancer diagnosis as traumatic event, which is debatable according to DSM-5, 38% of stressors qualified as traumatic and six patients (2.1%) met criteria for cancer-related PTSD. DSM-5 criteria enable a clear identification of traumatic events in the context of cancer. This change may inform discussions on the appropriateness of PTSD in cancer patients and facilitates its differentiation from AjD. Larger studies need to validate our findings.